Whalio Doctors

NPI 1003145533

Ambitions of Idaho, INC

Organisation Mental Health Clinic/Center (Including Community Mental Health Center) Coeur D Alene, ID

Practice location

Address
1044 Northwest Blvd STE C, Coeur D Alene, ID 83814-2114
Phone
(208) 930-1740
Fax
(208) 930-1695

Authorised official

Name
Shane Hagel
Title
President
Phone
(208) 930-1740

Registered specialties (8)

Mental Health Clinic/Center (Including Community Mental Health Center) Primary
Ambulatory Health Care Facilities Taxonomy 261QM0801X
Professional Counselor
Behavioral Health & Social Service Providers Taxonomy 101YP2500X
Clinical Social Worker
Behavioral Health & Social Service Providers Taxonomy 1041C0700X
Child & Adolescent Psychiatry Physician
Allopathic & Osteopathic Physicians Taxonomy 2084P0804X
Case Management Agency
Agencies Taxonomy 251B00000X
Community/Behavioral Health Agency
Agencies Taxonomy 251S00000X
Adult Mental Health Clinic/Center
Ambulatory Health Care Facilities Taxonomy 261QM0850X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Residential Treatment Facilities Taxonomy 320900000X

Registry record

NPI
1003145533
Entity type
Organization
NPI issued
11 Dec 2009
Record last updated
12 Oct 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.